Individual provider Active NPI

Daniel Guzman, M.A., M.A. PH.D.

  • Clinical Psychologist
  • Tulsa, OK
National Provider Identifier
1497481766
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1464 Issued in OK
Practice address
550 S Peoria Ave
Tulsa, OK 74120-3820
Phone
(918) 588-1900
Fax
(918) 382-1285
NPI assigned
Jul 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1464 OK Primary

Addresses

Primary practice location

550 S Peoria Ave
Tulsa, OK 74120-3820

Mailing address

550 S Peoria Ave
Tulsa, OK 74120-3820
Phone (918) 588-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240917002694 OK Practitioner - Clinical Psychologist 1254872393 Reassigns benefits to 1 organization
I20250923000681 TX Practitioner - Clinical Psychologist 1254872393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2029 /2 E 2ND St
Tulsa, OK 74104-1805

550 S Peoria Ave
Tulsa, OK 74120-3820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1464OKMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Indian Health Care Resource Center CurrentSince Aug 28, 2024 Accepting new patients
Indian Health Care Resource Center of Tulsa, Inc. PastSince Jul 31, 2022 Accepting new patients

Locations

550 S Peoria Ave
Tulsa, OK 74120
Phone (918) 382-1207

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1497481766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741203820",
            "telephone_number": "918-588-1900",
            "fax_number": "918-382-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741203820",
            "telephone_number": "918-588-1900",
            "fax_number": "918-382-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "DANIEL",
        "credential": "M.A., M.A. PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-28",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "1464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.